Active NPI
Daniel Kevin Byrd, DDS
- General Practice Dentistry
- Omaha, NE
National Provider Identifier
1902162860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5711
- Practice address
- 5200 N 91St Ave
Omaha, NE 68134-2749 - Phone
- (402) 572-7677
- Fax
- (402) 573-5486
- NPI assigned
- Apr 5, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5711 | NE | Primary |
Addresses
Primary practice location
5200 N 91St Ave
Omaha, NE 68134-2749
Mailing address
5200 N 91St Ave
Omaha, NE 68134-2749
Phone (402) 572-7677
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 122300000X | Medicaid | NE | |
| 04857 | Other | NE | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5711 | NE | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335225600000",
"number": "1902162860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5200 N 91ST AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681342749",
"telephone_number": "402-572-7677",
"fax_number": "402-573-5486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5200 N 91ST AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681342749",
"telephone_number": "402-572-7677",
"fax_number": "402-573-5486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BYRD",
"first_name": "DANIEL",
"middle_name": "KEVIN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-04-05",
"last_updated": "2012-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NE",
"license": "5711",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "122300000X",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "04857",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.